OPP Attends Briefing on Comparative Effectiveness Research
December 17, 2009
On Tuesday, December 15 th , representatives from the Office of Public Policy attended a briefing sponsored by the American Association for the Advancement of Science (AAAS) and the Hastings Center on Comparative Effectiveness Research. The briefing focused on several aspects of CER, including the controversy that surrounds it, the ways that the healthcare reform bills address it, and ways to make CER more “user-friendly” to the public.
First, however, we should define exactly what CER is. Simply put, Comparative Effectiveness Research is a research method in medicine that involves comparing the performance of separate treatments and seeing which one works best to alleviate and cure the ailment. CER allows us to determine exactly how effective any medical treatment is. Essentially it is the method by which we arrive at evidence-based medical procedures. Without CER, we would have no means of judging which medical procedures work best to cure individuals.
In fact, while most individuals think that all medical procedures—both drug and surgery related—are evaluated and tested before they are offered to the public, the reality is that fewer than half of all medical interventions used today are supported by scientific evidence, according to a recent Institute of Medicine report. Comparative Effectiveness Research is the primary way to vet these medical procedures and make sure that we are offering the best, most effective care we can to the sick.
This methodology has, however, generated a great deal of controversy among different groups over the years. While in principle, testing medical interventions to determine their effectiveness is a good idea, many fear of what CER could result in, if implemented in the wrong ways. Many people believe that CER will lead to rationing. As treatments are found to be “ineffective,” or “not worth the cost,” they could be dropped from health coverage or have access to them restricted. Others argue that CER will lead to a “one size fits all” model of healthcare, when different treatments are in reality often appropriate for different groups of people. Additionally, some individuals often worry that CER will stifle innovation and may not actually save any money, as some propose it will do through the elimination of unnecessary treatments.
Additionally, we learned about the provisions in the current healthcare bills before Congress that directly address CER. The version of health care reform that passed the House of Representatives would create a governmental agency to conduct CER on a wide array of medical procedures, much the same way that the FDA currently tests drugs before granting its approval. Treatments approved by this agency would carry the weight of proven effectiveness, again much the same way that FDA approval carries weight for drug related treatments. On the Senate side, their version of healthcare reform would create and independent non-profit group, governed by a board of stakeholders (doctors, nurses, pharmaceutical producers, etc) and overseen by the government. This would operate much the same way as the Federal Reserve does today.